Our Medicare and Medicaid solutions include market-leading software coupled with infrastructure, advisory, and business process services needed for plans to compete and succeed in these highly regulated health plan environments.

Cognizant Government Solutions

Our Medicare and Medicaid solutions include market-leading software coupled with infrastructure, advisory, and business process services needed for plans to compete and succeed in these highly regulated health plan environments.

Cognizant/TMG Health BPaaS Solutions

Business Process-as-a-Service (BPaaS) solutions allow you to focus on core business opportunities and free up capital to invest in innovation. Our government programs BPaaS brings together automation, expert insight, best-in-class industry processes and platforms, and an outcome-driven, integrated service delivery and program governance framework.

Managing your government programs with our BPaaS solution provides you the ability to leverage best-in-class technology built on standard configurations without major capital outlays. That technology, combined with our team of government programs subject matter experts, can support end-to-end capabilities across your business and address the pressures of both Medical Loss Ratio (MLR) and Administrative Loss Ratio (ALR), enabling you to focus on:

The Case for BPaaS

Healthcare is at a point of convergence – industry shifts are impacting the way healthcare is done today.

While there are many factors contributing to the industry-wide shift, as-a-service models are changing how businesses are investing in technology and providing the necessary operational agility to expand as the market grows.

Given the current political climate, financial pressures and compliance requirements that government health plans are now experiencing, as-a-service models are the way forward.

November 1, 2018 - Time.com
Obamacare open enrollment begins today for the roughly 11 million Americans who buy individual coverage through healthcare.gov or their state exchange. In most states, open enrollment for 2019 Affordable Care Act (ACA) coverage runs through December 15:

October 31, 2018 - Modern Healthcare:
The CMS wants to make a few dramatic changes to the way it audits Medicare Advantage plans for over-payments, which could leave insurers on the hook for billions of dollars:

September 11, 2018 - InformNY
Health Officials said the only way to save yourself from the flu virus is to get a flu shot. They said the high numbers seen last year were due in part because people weren't getting vaccinated.

September 11, 2018 - The Joint Commission
As health care delivery transitions from acute inpatient settings to outpatient settings, there is a growing need to address outbreak and patient notification events related to lapses in infection control in outpatient settings.